Under what condition can a carrier disenroll a consumer?

A carrier can disenroll a consumer when the consumer does not pay their premiums because premium payment is a fundamental requirement for maintaining coverage in a health insurance plan. When premiums are not paid, the carrier has the right to terminate the policy due to non-payment, as this violates the terms of the insurance agreement.

This is a standard practice across most insurance markets to ensure that carriers can continue to provide coverage to all members without the financial strain that comes from unpaid premiums. Other options, while they touch on relevant scenarios, do not align with established policies. For instance, a consumer requesting disenrollment typically leads to an initiated process rather than an automatic disenrollment. Disenrollment solely at the carrier's discretion without cause or justifiable reason creates ethical and legal complications. Additionally, reaching retirement age does not inherently provide a basis for disenrollment under the terms of the policy; rather, it may affect eligibility for other types of coverage, such as Medicare.